Besin Proteini İlişkili Enterokolit Sendromlu Hastaların Klinik Özelliklerinin Değerlendirilmesi: Tek Merkez Deneyimi

Besin proteini ilişkili enterokolit sendromu (BPİES), nadir görülen immünoglobulin E (IgE) aracılı olmayan bir besin alerjisidir. Haziran 2021 ile Aralık 2022 tarihleri arasında takip edilen 17 BPİES tanılı hastanın klinik ve demografik özellikleri, tetikleyici besinleri ve tolerans durumları retrospektif olarak kaydedildi. BPİES tanısı alan %58,8’i (n=10) erkek, 17 hasta çalışmaya alındı. Semptom başlangıç yaşı ortanca (çeyrekler-arası) 6 ay (5-7,5 ay) ve tanı yaşı ise ortanca 7,7 ay (5,5-27,3 ay) idi. On yedi hastanın, 15’ine akut BPİES, 2’sine kronik BPİES tanısı konuldu. Akut BPİES’i olan hastalarda en sık tetikleyici besinler yumurta (n=6), inek sütü (n=4) ve balık (n=3) idi. Kronik BPİES’li hastalarda tetikleyici besin olarak sadece inek sütü (n=2) saptandı. En sık görülen klinik semptomlar, sıklık sırasına göre kusma (%100), solukluk (%77,8), letarji (%38,9) ve ishal (%38.9) idi. On yedi hastanın sekizi (%47,1) tetikleyici besine tolerans geliştirdi. Tolerans yaşı ortanca 23,5 ay (18,3-29,5 ay) idi. Balık BPİES olan hastaların hiç birinde tolerans gözlenmedi. Tolerans geliştiren ve tolerans geliştirmeyen hastaların özellikleri ve laboratuvar bulguları karşılaştırıldığından iki grup arasında istatiksel olarak anlamlı fark saptanmadı (p>0,05). BPİES’te prognoz genellikle iyidir ve hastaların yarısından çoğu 5 yaşına kadar tolerans geliştirir. Bu çalışmada, yumurta, inek sütü ve balığın en sık tetikleyici üç besin olduğu saptandı. Hastaların yaklaşık yarısı ortanca 23,5 ayda tolerans geliştirmişken, balık BPİES olan hastaların hiçbirinde tolerans gözlenmedi.

Anahtar Kelimeler:

Besin Alerjisi, Besin proteini ilişkili enterokolit sendromu, Çocuk, Tetikleyici besin, Tolerans

Evaluation of Clinical Characteristics of Patients with Food Protein-Induced Enterocolitis Syndrome: A Single-center Experience

Food protein–induced enterocolitis syndrome (FPIES) is a rare non-IgE mediated food allergy. The clinical and demographic characteristics, culprit foods and tolerance status of 17 patients with a diagnosis of FPIES who were followed up between June-2021 and December-2022 were recorded. Seventeen patients consistent with 58.8% (n=10) males diagnosed with FPIES were included in the study. The median (interquartile range) age of symptom onset was 6 months (5-7.5months) and the median age at diagnosis was 7.7 months (8–20months). Of 17 patients, 15 were diagnosed with acute FPIES and 2 were chronic FPIES. The most common culprit foods in acute FPIES were hen’s egg (n=6), cow's milk (n=4), and fish (n=3). Cow's milk (n=2) was the only culprit food in chronic FPIES. The most common clinical symptoms were vomiting (100%), pallor (77.8%), lethargy (38.9%), and diarrhea (38.9%). Eight patients (47.1%) achieved tolerance and the median age at tolerance was 23.5 months (18.3-29.5months). Tolerance was not observed in any patients with fish FPIES. There was no statistical significant difference in the characteristics and laboratory findings of patients between the groups who developed tolerance and did not tolerance (p>0.05). The prognosis of FPIES is generally acceptable and more than half of the patients acquire tolerance until 5 years. In this study, hen's egg, cow's milk, and fish were the most common culprit foods. While approximately half of the patients achieved tolerance at a median age of 23.5 months, none of the patients with fish BPIES were tolerant.

Keywords:

Children, Culprit food, Food allergy, Food protein induced enterocolitis syndrome, Tolerance,

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